The project employed eight of our first cohort of BMET graduates (pictured). On arrival at their assigned hospitals, they found that on average only 71% of medical equipment was functional. The rest was often just standing around and had been in this condition for some time. Eight months later, at the end of the project, they had managed to increase the Uptime to 93%. A result to be proud of! We analyzed that this Uptime number could even have been 98% if a modest additional amount of money had been made available for the procurement of spare parts. Unfortunately, there are no budgets reserved for equipment maintenance in the government hospitals. Hospital management has to weigh monthly the procurement of spare parts against the (more?) urgent needs for pharmaceuticals, food, fuel, etc.
Preventive maintenance and user training programs were also started. The number of corrective repair actions went down over time. It became clear already that the role of the Biomedical Engineering Technologists (BMETs) will gradually develop from equipment repair to prevention and management, as in most high-income countries.
A business case was made to evaluate the financial impact of an in-house equipment maintenance service. It proved beyond doubt that it is wasteful to procure new equipment without providing professional maintenance. In that case, on average 30% of the procurement value will be lost during equipment down time and even more may be lost by the reduction in expected life time of non-maintained equipment.
As part of the sustainability of this work, THET has now developed a plan to roll out an in-house medical equipment maintenance service across all government hospitals in the country. The Ministry of Health and various Cooperating Partners are now considering this plan. If it is accepted, my work in Zambia may continue……